KENNETH DALE KITTLESON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

KENNETH DALE

Last Name

KITTLESON

Suffix

Business Name

KENNETH DALE KITTLESON MD

Original Issue Date

09/10/1996

Effective Date

06/16/2008

Expiration Date

07/31/2011

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011